喉部动脉的特点及意义

发布时间：2018-01-14 20:10

本文关键词：喉部动脉的特点及意义　出处：《重庆医科大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的研究喉部动脉分布的形态学特点,为喉部肿瘤的三维放射治疗、喉移植及喉部修复重建提供解剖学基础。方法10例(1至10号标本)结构完整的喉部标本铸型,用盐酸腐蚀,观察喉部动脉分支,游标卡尺测量血管经线;20例(11至30号标本)结构完整的喉部标本用过氯乙稀和硫酸钡混合铸型,采用美国GE Signa MR/i型1.5T等全身MR扫描仪和德国西门子Somatom Esprit CT水平面和矢状面的扫描,获得喉部血管的影像学数据;20例(11至30号标本)结构完整的喉部标本铸型,进行1mm/片磨铣,进一步确定喉部动脉与周围器官组织的位置关系,对供应喉部血液的血管进行定位分析;10例(31至40号标本)动脉铸型的喉部标本在体视显微镜(coic xtl 23:7.5-30倍)下进行观察。对喉部动脉分支分布走行进行定量分析。结果喉部血供主要来自甲状腺上动脉和甲状腺下动脉分支,左、右甲状腺上动脉的长度为(4.2±0.2)cm和(4.0±0.2)cm,起始点的口径为(1.5±0.3) mm,甲状腺上动脉入喉后分出7个主要分支,分别为甲状腺上动脉第1分支--第7分支,主要供应甲状腺包囊及结缔组织,位置较浅;左、右甲状腺下动脉的长度为(2.3±0.27)cm和(2.2±0.27) cm,起始点的口径为(1.6±0.37)mm,入喉点口径为(1.4±0.3) mm和(1.3±0.3) mm。沿前斜角肌内缘上行,约至第6颈椎水平,便急转向内,横过颈长肌和椎动脉的前方,颈内静脉,颈总动脉,迷走神经及交感神经干的后方,至甲状腺后缘中点处附近转向下行,甲状腺下动脉入喉后分出4个主要分支,分别为甲状腺上动脉第1分支--第4分支,分别至甲状腺,气管及食管等器官。结论采用这4种不同的形态学研究方法对喉部动脉分支分布走行特点的观察分析和定量研究,较详细的获得了喉部动脉的走行分布大小及分布位置,以及喉各部位的血管供应情况。喉动脉铸型标本能较详细清楚观察动脉细小分支走行及分布范围,动脉与喉部组织关系位置显示欠佳,而MRI和CT扫描确定位喉动脉与喉部其他组织结构组织的位置关系,但微细结构分辨力欠佳,冰冻磨铣法可更直观显示喉部动脉与喉不同层面的关系,对MRI和CT扫描喉动脉血管起到很好的补充作用,体视学研究能准确的对喉动脉分支分布数量进行定量。影像学技术对喉肿瘤三维放射治疗,喉移植及喉部位修复重建作为临床医疗诊断和影像学检查的重要辅助手段,更适合于临床。
[Abstract]:Objective to study the morphological characteristics of laryngeal artery distribution in laryngeal neoplasms. Methods the cast of laryngeal specimens with intact structure was observed by hydrochloric acid corrosion, the branches of laryngeal arteries were observed, and vascular meridians were measured by Vernier calipers. 20 specimens from 11 to 30) the laryngeal specimens with intact structure were cast by mixed casting of perchloric ethene and barium sulfate. The horizontal plane and sagittal plane were scanned by GE Signa MR/i 1.5T and Siemens Somatom Esprit CT in Germany. The imaging data of laryngeal vessels were obtained. 20 specimens from 11 to 30) of larynx with intact structure were molded and milled with 1mm / slice to determine the relationship between the laryngeal artery and the surrounding organs and tissues. The blood vessels supplying laryngeal blood were analyzed. Laryngeal specimens of arterial cast in 10 specimens from 31 to 40) in stereoscopic microscope: 23: 7.5-30 times). The results showed that the blood supply of larynx mainly came from superior thyroid artery and inferior thyroid artery branch. The length of the left and right superior thyroid arteries was 4.2 卤0.2 cm and 4.0 卤0.2 cm respectively. The diameter of the starting point was 1.5 卤0.3 mm. After entering the larynx, the superior thyroid artery was divided into seven main branches, the first branch and the seventh branch of the superior thyroid artery, which mainly supplied the thyroid cyst and connective tissue. The length of the left and right inferior thyroid arteries was 2.3 卤0.27 cm and 2.2 卤0.27 cm respectively. The diameter of the starting point was 1.6 卤0.37 mm. The laryngeal entry point was 1.4 卤0.3 mm in diameter and 1.3 卤0.3 mm in diameter. It ascended along the inner edge of the anterior scalene muscle and reached the level of the 6th cervical vertebra, then quickly turned inward and crossed the front of the longus cervicalis muscle and the vertebral artery. The posterior part of internal jugular vein, common carotid artery, vagus nerve and sympathetic nerve trunk turned downward to the midpoint of the posterior edge of thyroid gland, and the inferior thyroid artery was divided into four main branches after entering the larynx. It is the first branch of the superior thyroid artery-the fourth branch, respectively, to the thyroid gland. Conclusion the characteristics of branch distribution of laryngeal artery were observed and analyzed quantitatively by using these four different morphological methods. The size and location of the laryngeal artery and the vascular supply of the laryngeal artery were obtained in detail. The patchwork of the laryngeal artery can clearly observe the route and the distribution range of the fine branches of the larynx artery. The location of the relationship between the artery and the laryngeal tissue was poor, while the location of the laryngeal artery and other laryngeal tissue was determined by MRI and CT scanning, but the resolution of the fine structure was not good. Frozen grinding and milling method can show the relationship between laryngeal artery and laryngeal artery more directly, which is a good supplement to MRI and CT scanning of laryngeal artery vessels. Stereological study can accurately quantify the number of branches of laryngeal artery. Imaging techniques for three-dimensional radiotherapy of laryngeal tumors. Laryngeal transplantation and laryngeal reconstruction are important auxiliary methods for clinical diagnosis and imaging examination, and are more suitable for clinical use.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R322.121

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